Evaluation of RIPASA Score Compared to Modified Alvarado Score in the Diagnosis of Acute Appendicitis

Objective: The diagnosis of acute appendicitis is still a challenge because it is a common yet difficult surgical illness. Since there are numerous clinical mimics and the diagnosis is mostly based on clinical criteria, clinical scoring systems have developed to help identify the correct diagnosis. This study aims to evaluate the diagnosis precision in acute appendicitis with a lower rate of negative appendectomy; by comparing the RIPASA score with the modified Alvarado score on patients undergoing emergency appendectomy. Material and Methods: Over a two-and-a-half-year period, we prospectively compared the two scoring systems in 103 patients undergoing an emergency appendectomy to treat acute appendicitis. Statistical analysis was comparatively done by ANOVA utilizing statistical software (SPSS), Microsoft Excel datasheets, and calculation of statistical significance using the McNemar Chi square test. Results: The RIPASA scale was more appropriate than the modified ALVARADO scale, according to the diagnostic accuracy results, which were 95.15% for the RIPASA score and 64.08% for the Modified Alvarado score. Conclusion: Thus based on the greater sensitivity, the RIPASA score is a better tool in the evaluation of suspected appendicitis in the South Asian population.      研究目的：急性阑尾炎（acute appendicitis）的诊断仍是一项临床挑战，其作为常见外科疾病却诊治难度较高。由于存在诸多临床相似病症，且诊断主要依赖临床评判标准，临床评分系统应运而生以辅助明确诊断。本研究旨在通过对比接受急诊阑尾切除术患者的RIPASA评分（RIPASA score）与改良Alvarado评分（modified Alvarado score），评估急性阑尾炎的诊断精准度并降低阴性阑尾切除术发生率。 材料与方法：本研究在两年半的周期内，前瞻性纳入103例因急性阑尾炎接受急诊阑尾切除术的患者，对两种评分系统进行对比分析。采用方差分析（ANOVA）开展对比性统计分析，借助统计软件SPSS、Microsoft Excel数据表完成相关运算，并通过McNemar卡方检验计算统计学显著性。 结果：诊断准确率结果显示，RIPASA评分的准确率为95.15%，改良Alvarado评分的准确率为64.08%，提示RIPASA量表优于改良Alvarado量表。 结论：综上，基于更高的敏感度，RIPASA评分是评估南亚人群疑似阑尾炎的更优工具。